Low cost family therapy

The goal of systemic family therapy is to highlight negative patterns of behavior. find their roots, work through and help the family find a balance between emotional contact and individualization.

How the CCT works

In the first session, the therapist clarifies the problem and the history of the family. It focuses on the main points:

Relationships of all family members

Relationships and communication features appear in significant situations. The therapist asks family members to take turns describing an event and looks at their interactions—in the stories themselves and in the course of therapy. nine0011

Public and unspoken rules in the family

Rules are how a family lives, how responsibilities are distributed in it, how family members communicate with each other. Examples of a family rule: "The woman is responsible for all housework", "Children have no right to argue with their elders." Not everyone may agree with the rule, but they still abide by it.

Family myths

A family myth is an unspoken image of a family that is supported by all its members. For example: “We are a friendly family and never swear.” Conflicts and contradictions in such a family can be hushed up so as not to destroy the myth. For the sake of the myth “Mom is our savior”, all other family members will constantly get into trouble so that there is someone to save. Anyone who threatens the myth with his behavior can be severely punished - up to and including exclusion from the system. nine0011

Family boundaries

Each family member has an idea of ​​who belongs to the family. This representation can be different: for example, the wife includes her parents in the system, while the husband does not consider them members of the family. This discrepancy leads to serious disagreements.

“Before the family comes to the session, I form a hypothesis: what is happening to these people that brought them to therapy. At the session, the first stage is the collection of information and acquaintance. I ask about professions, education, background. This is very important and affects relationships. After all, if he is a professor of mathematical sciences, and she is a manicurist, most likely they speak different languages. I ask if the person has “his” place in the apartment where he can be alone. Information that at first glance has nothing to do with a family problem can be very important. ” nine0011

Olesya Kruglushina, systemic family therapist:

“The systems approach can work with the whole family, with a couple and even individually. Sometimes not all family members want to come to therapy. It happens that a client stays or comes to individual work - and becomes an agent of change in his family. SST allows you to build a line of therapeutic work quite flexibly. For example, in working with a family where there is a teenager, family meetings can be sequentially organized, paired, individual with a teenager and each parent, and then again joint sessions. This is decided on a case-by-case basis." nine0011

Anna Guseva, systemic
family therapist:

As a rule, work in the STS is divided into 4 stages:

Making a family diagnosis

"Family diagnosis" is not a medical term and not a psychiatric conclusion. This is the reason why there is a problem in the family.

Elimination of the conflict

After clarification of the main conflict, it must be eliminated. To do this, the therapist uses specific techniques to reduce the anxiety associated with the problem and teach family members to respond differently. nine0011

Reconstruction

Reconstruction is a change in the dysfunctional model itself, which causes conflicts. If you don't change it, it's a problem. most likely to return some time after therapy.

Support

Discussing the results, expressing thoughts and feelings on the subject reinforces the effect of therapy. So after the request is satisfied. it is helpful to have a few supportive sessions. There are cases when the family visits the therapist regularly - to prevent subsequent problems. nine0011

In the course of his work, the systemic family therapist uses various techniques that are unique to this type of therapy.

Genogram

The easiest way to trace the history of a family is to use the genogram technique. The therapist draws a detailed family tree with the family. On it, he notes the ties between relatives and important moments in history: marriage and divorce, the peculiarities of raising children and communicating with parents. The genogram clearly shows what expectations each spouse has from family life. nine0011

“From childhood, we adopt certain family rules. How a family should function, how a wife and husband should behave, how to raise children, how to distribute finances. This is passed down from generation to generation. When we draw a genogram, a family symptom is immediately visible. There is always a relationship: some generations already had the same symptom. It is also seen that family rules in one and the other genus may not coincide.

For example, in the family the boys' wives were very protective, relieved of any work, "fed" and took care of them. And in the husband's family there was a rule "You are a man, you must help." Such a couple will quarrel even because of mopping: each will strive to do it on their own. As a result, the wife will feel rejected (“He doesn’t need my care and love”), and the husband will feel humiliated (“Is there nothing I can do?”). nine0011

Olesya Kruglushina, systemic family therapist:

Circular interview

Circular interview is a technique that is widely used in family therapy. The therapist takes turns asking all family members the same question—sometimes worded differently. A circular interview helps to clarify the attitude of each family member to a problematic situation - as well as to show everyone the hidden motives of their actions and words. However, the therapist usually does not ask about the thoughts and feelings of the client. It only shows how the whole situation looks from the outside, what patterns it reflects - and it becomes clear to everyone why this situation is happening. nine0003

Examples of questions in a circular interview:

— How does the situation look like now?

— When did the situation first arise? Why do you think this happened?

— How do you deal with this situation?

- What do you get when this situation occurs?

— If the situation continues in the future, what will it lead to?

Positive reformulation

Once the therapist has made a "family diagnosis", he helps the client change his attitude towards the problem. First, he tells the family that their problem is not unique and that many are experiencing it. It takes some of the stress off. Then he draws attention to the advantages of the situation and positive motives for behavior. For example, “you are so protective of your son because you are a very caring person, and you are afraid of losing him.” Then he draws attention to the fact that the chosen behavior does not correspond to the motives that prompt it - it even contradicts them. For example, by overprotecting the child, the mother does not contribute to his safety - because in this way he does not learn to cope with difficult situations. nine0003

The last step of this work is prescription . The therapist helps the family formulate a new rule and gives homework to follow it.

What problems are solved at SST

SST deals with any problems related to family relations. You can contact a therapist if:

You find it difficult to negotiate and resolve conflicts within a couple (even if you are not officially married)

One of the family members has an emotional or mental disorder that affects relationships within the family

The child has problems with socialization, academic performance or health (especially for psychogenic illnesses)

You cannot find a common language with the child or teenager

The composition of the family has changed: a new child has appeared or, on the contrary, the child has grown up and started an independent life. All family members need to adapt to new conditions

You are going through a divorce and creating new families

You are experiencing the death of a family member

“Most requests are related to marital and parent-child relationships. Individual clients come with very different questions: difficulties in creating long-term relationships, dissatisfaction in relationships with a partner and the world, experiencing crises and losses, the inability to decide on some important life choices, addictions.

Perhaps the most complex requests for each specialist will be different. Someone is better at dealing with divorces or parent-child relationships - and he will “transfer” clients with addiction to colleagues. Some find it difficult to work with conflicting families, while others find it difficult to work with distant ones. But for difficult cases, there are always supervisions and personal psychotherapy.” nine0011

Olesya Kruglushina, Systemic Family Therapist:

CCT may be short-term: some problems can be solved in a few sessions. This usually refers to problems that have arisen recently. If the tension has built up over the years, more time will be needed. But it is impossible to accurately determine the required number of sessions - it is individual for each family.

Emotion Focused Therapy: Couple Dance

Emotion Focused Therapy (EFT) is designed for couples. It helps to overcome the crisis of relations, to make them closer and more trusting. One of the founders of the approach compared EFT to choreography: "the therapist acts as a choreographer for staging a pair dance." nine0011

EFT was based on the attachment theory of psychoanalyst John Bowlby. He worked with children - in particular, he observed how children develop and behave in orphanages. Bowlby noted that these children often suffer from emotional problems and find it difficult to establish contacts and long-term relationships. He suggested that this is due to the lack of experience of close attachment to the mother. Then John Bowlby began to develop his theory of attachment, according to which the behavior of people in relationships depends on what kind of contact they had in childhood with their parents (in particular, with their mother). The fear of loneliness or overprotection is formed in childhood and remains with people for life. Because of this, they develop insecure attachment styles that prevent them from building strong close relationships. nine0003

EFT was created by Canadian psychologists Susan Johnson and Leslie Greenberg. They started developing the approach in the 80s. Methodologically, it is similar to the synthesis of Rogers' client-centered therapy and CCT. From client-centered therapy, EFT took the emotional involvement of the therapist and the nonjudgmental acceptance of the client. From SST, the idea that relationships are affected by negative patterns.

The approach has been constantly developed and improved. In 1998, Susan Johnson created The International Center for Excellence in Emotionally Focused Therapy, which trains and certifies EPT therapists and conducts clinical research. It is now an internationally recognized method of couples therapy. nine0011

Historical background

Basic principles of ETF

Bowlby found that many people develop insecure attachment styles that interfere with relationships. The goal of EFT is to help change the attachment style to one that is secure and secure. A person with a secure type of attachment is not afraid of being abandoned or "strangled" by love, does not control a partner and does not manipulate him. He enjoys an emotional connection, a relationship for him is a “safe bay”, where you will always be accepted and supported. nine0011

Emotions are the key to creating a secure attachment

As the name implies, EFT focuses on emotions. Through emotions we perceive and evaluate reality. Negative emotions once led to the formation of an insecure attachment style.

The need for affection is healthy and natural

All people desire affection: it is genetically determined. Historically, those who knew how to call for help and accept support survived. Only the ways in which people try to satisfy the need for attachment can be maladaptive. nine0011

Interaction is cyclical and patterns

One reaction provokes another. The behavior of the couple “enters” a cycle from which it is difficult to break out.

Change occurs through new emotional experience

In therapy, the couple receives new emotions - from communication with the therapist and with each other. This experience provokes change.

How EFT works

Johnson and Greenberg formulated 3 stages of work in EFT, each of which consists of several steps:

Step 1. Form a therapeutic alliance and discuss the request.
Step 2: Finding the Negative Cycle
Step 3: Dealing with the Emotions That Triggered the Cycle
Step 4: Redirecting the Problem: Common Enemy – Negative Cycle that Causes Stress and Conflict

Step 5: Articulating Needs and Emotions . Partner interaction.
Step 6: Work on acceptance: The therapist teaches partners to express empathy and support, to accept each other's needs and emotions. nine0011 Step 7. Work on the style of attachment: the “withdrawal” partner learns to engage in an emotional connection, and the “accusing” partner learns to behave more freely.

Step 8. Form new ways to behave and discuss problems.
Step 9. Use the skills learned in therapy outside the office. Consolidation of results.

At each stage, the therapist uses techniques specific to EFT.

Reflection Technique

This technique is borrowed from Rogers' client-centered therapy. The therapist "returns" to the client his vision of the situation. He literally repeats the words of the client, highlighting the most emotional and significant moments with intonation. This contributes to the creation of a therapeutic alliance. nine0011

Confirmation Technique

Therapist accepts the client's thoughts and feelings; shows that they are completely normal and natural. Confirmation is not approval. It is important for the therapist to remain neutral and not take sides with either partner. Its purpose is to show partners that their emotions are important and their reactions are understandable.

Empathic Suggestion Technique

The therapist guesses what deep emotions may lie behind the client's story. Sometimes we mask true, primal emotions with ones we have "learned" to experience—more socially acceptable and less traumatic. In therapy, it is important to “raise” the primary emotions and work through them. nine0011

Feeling Questions

When a therapist notices a particular reaction in a client, he may ask, "What did you feel at that moment?" "What prompted you to do this?" By asking questions, he invites the client to explore his own emotional world.